MEDICARE: REID AND YATES PHYSICAL THERAPY INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1144259318
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REID AND YATES PHYSICAL THERAPY INC

Provider Business Mailing Address
First Line	:	1825 N WILLIAMS AVE
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97227-1864
Country	:	US
Telephone Number	:	503-288-2615
Fax Number	:	503-288-0339

Provider Business Practice Location Address
First Line	:	1825 N WILLIAMS AVE
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97227-1864
Country	:	US
Telephone Number	:	503-288-2615
Fax Number	:	503-288-0339

Authorized Official
Title or Position	:	CO-OWNER
Name	:	ROCKWOOD ILES REID
Credential	:	PT
Telephone Number	:	503-288-2615

Provider Enumeration Date	:	07/01/2006
Last Update Date	:	08/22/2020

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